Provider Demographics
NPI:1326599986
Name:METROPOLITAN PEDIATRICS PC
Entity Type:Organization
Organization Name:METROPOLITAN PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SASALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-496-6400
Mailing Address - Street 1:254 W 87TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2706
Mailing Address - Country:US
Mailing Address - Phone:212-496-6400
Mailing Address - Fax:
Practice Address - Street 1:254 W 87TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2706
Practice Address - Country:US
Practice Address - Phone:212-496-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212405208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty